Can Nocturia Hasten Death?

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Having 3 or more voids per night was associated with 72% excess death risk.
Having 3 or more voids per night was associated with 72% excess death risk.

Nocturia is more than a mere nuisance. Study findings presented at the AUA 2018 meeting and now published in Prostate Cancer and Prostatic Diseases suggest that relatively healthy men who awaken often to urinate have increased risks for death.  

Donald L. Bliwise, PhD, of Emory University School of Medicine in Atlanta and his peers analyzed data from 7343 mostly white participants (aged 50–75) in the REDUCE trial (Reduction by Dutasteride of Prostate Cancer Events). Men who reported 3 or more voids per night had a 72% greater risk for all-cause mortality. The investigators adjusted models for demographics, smoking, alcohol, and morbidities (e.g., coronary artery disease, diabetes, hypertension, and peripheral vascular disease). They also considered treatment with dutasteride and diuretics, as well as prostate volume.

When disturbed sleep, measured by the Medical Outcomes Study questionnaire, was finally added to the model, the excess death risk fell to 43%. According to the researchers “…disrupted sleep should be considered the major factor underlying this relationship.” Nocturia can lead to poor sleep and vice versa, they noted. The researchers also acknowledged that falls may play a role, since falling has been linked to both nocturia and death.

Whether treating nocturia can improve mortality remains to be seen. “Such recognition should hasten a clinician's decision to take the presence of the condition more seriously and consider treatment options currently available,” Dr Bliwise and the team concluded.

Reference

Bliwise DL, Howard LE, Moreira DM, Andriole GL, Hopp ML, Freedland SJ. Nocturia and associated mortality: observational data from the REDUCE trial. Pros Canc Prost Dis. DOI:10.1038/s41391-018-0090-5

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